Organization Name: | TIMOTHY OCONNOR MD PC |
NPI Number: | 1225346281 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TIMOTHY OCONNOR (MEDICAL DOCTOR) |
Mailing Address: | 333 Magazine St Ste 102 Sault Sainte Marie |
State: | MI US |
Postal Code: | 497831867 |
Phone Number: | 9062539374 |
Fax Number: | 9062539002 |
NPI Enumeration Date: | 09/23/2010 |
NPI Last Update Date: | 09/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | 4301058216 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |